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how low can cd4go during primary infection before treatment required

Aug 15, 2004

Forty days after infection I experienced seroconversion illness lasting several days. A week later, my CD4s were 807, CD8s 497. I hoped to wait a few years before starting treatment, but wanted to monitor my condition, especially in the early stages. Two weeks later, my CD4s are 410, CD8s 391. I am afraid that if my CD4s continue to drop at this rate, there will be a danger of swift progression even though I know that there may be a rebound after primary infection.

I have read that people can generally live with the virus for an average of 5 to 10 years without needing treatment. If CD4s drop into AIDS levels during primary infection, does this mean that treatment is essential, or are they likely to improve within a few months?

Response from Dr. Holodniy

It would not be unusual during acute infection to see CD4 counts decline to a level such as you describe. The counts usual increase within several weeks after seroconversion. It's hard to know whether return to preinfection levels because it's rare to have people get CD4 counts before infection to know where they started from. Dropping to AIDS levels (i.e. < 200) would be unusual.

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